儿童甲状旁腺功能减退症15例临床分析

Clinical Study on Fifteen Children with Hypoparatheroidism

目的:提高对儿童甲状旁腺功能减退症(简称甲旁低)的临床认识和诊治水平,减少误诊和漏诊。方法:回顾性分析了我院内分泌科收治的15例儿童。结果:15例患者以女性为主(9例),分型以假性甲旁低为主(10例)。临床表现以手足抽搐最多见(13例)。实验室检查以低钙血症,高磷血症最多见(15例)。血清甲状旁腺激素(PTH)可减低,正常或升高。11例患者(73%)对钙剂和罗钙全治疗反应良好。结论:儿童甲旁低多以手足抽搐为首发症状,共同表现为低钙,高磷血症,对抽搐患儿应常规做血钙、磷、PTH等检查,以尽早确诊。治疗原则是尽快纠正低钙血症。

Objective: To improve the ability of diagnosis and treatment to patients with hypoparatheroidism, reduce the misdiagnosis and missed diagnosis of such patients. Method: The clinical data of fifteen patients with hypoparatheroidism admitted to our hospital from 1999 to 2004 were analyzed retrospectively. Result: 15 cases were analyzed, 9 of them were girls, the others were boys. 10 of them were diagnosed as pseudohypoparatheroidism. Convulsion was the most common manifestation.(14 cases). Hypocalcemia and hyperphosphatemia were manifested in all cases. The level of serum parathormone was low, normal or high . After treated with calcium agent, the manifestation disappeared in 11 cases.(73%). Conclusion: Convulsion was usually the most common manifestation of children with hypoparatheroidism , all of them suffered from hypocalcemia and hyperphosphatemia. Blood calcium, blood phosphonium and serum parathormone should be examined in convulsive patients conventionally in order to make an explicit diagnosis as early as possible. The treatment is based on calcium therapy.